Summary
Objective: To determine the long-term risk of hip fracture following fracture of the distal forearm.
Design: Registry-based cohort study comparing patients with a fracture of the distal forearm with a population-based cohort.
Fracture cohort: All women and men above 40 years of age with a radiologically verified fracture of the distal forearm during a 5-year period. 1968–1972, in all 1,126 women and 212 men.
Control cohort: An equal number of population-based, age-and sex-matched control persons selected from a population register.
Measurements: All cohort members were followed up individually through record linkage until the first hip fracture, emigration, death, or the end of 1991. The cohort members contributed a total of 40,832 person-years of observation, and altogether 365 cases of hip fractures were observed.
Results: Both women and men with a fracture of the distal forearm ran an increased risk of sustaining a subsequent hip fracture. The overall relative hazard for the women was 1.54 and for men 2.27. The increased risk in the women was independent of age at inclusion, but that in the men was more pronounced in the younger age groups.
Conclusions: Patients with a fracture of the distal forearm run an increased risk of sustaining a subsequent hip fracture. They therefore appear to constitute a group in which appropriate prophylactic measures against osteoporosis and fractures should be considered.
Similar content being viewed by others
References
Bauer GCH (1960) Epidemiology of fracture in aged persons: a preliminary investigation in fracture etiology. Clin Orthop 19: 219–225
Bengnér U, Johnell O (1985) Increasing incidence of forearm fractures: a comparison of epidemiologic patterns 25 years apart. Acta Orthop Scand 56:158–160
Obrant KJ, Bengnér U, Johnell O, Nilsson BE, Sernbo I (1989) Increasing age-adjusted risk of fragility fractures: a sign of increasing osteoporosis in successive generations. (Editorial) Calcif Tissue Int 44:157–167
Mallmin H, Ljunghall S (1992) Incidence of Colles' fracture in Uppsala—a prospective study of a quarter million population. Acta Orthop Scand 63:213–215
Nilsson BE, Westlin NE (1974) The bone mineral content in the forearm of women with Colles' fracture. Acta Orthop Scand 45:836–844
Mallmin H, Ljunghall S, Naessén T (1992) Colles' fracture associated with reduced bone mineral content. Photon densitometry in 74 patients with matched controls. Acta Orthop Scand 63:552–554
Sernbo I, Johnell O (1989) Changes in bone mass and fracture type in patients with hip fracture—a comparison between the 1950s and the 1980s in Malmö, Sweden. Clin Orthop 238:139–147
Naessén T, Parker R, Persson I, Zack M, Adami HO (1989) Time trends in incidence rates of first hip fracture in the Uppsala health care region, Sweden, 1965–1983. Am J Epidemiol 130:289–299
Lawless JF (1982) Statistical models and methods for life-time data. John Wiley, New York
Persson I, Adami H-O, Bergkvist L, Lindgren A, Pettersson B, Hoover R, Schairer C (1989) Risk of endometrial cancer after treatment with oestrogens alone or in conjunction with progestogens: results of a prospective study. Br Med J 298:147–151
Alffram PA (1964) An epidemiologic study of the cervical and trochanteric fractures of the femur in an urban population. Analysis of 1,664 cases with special reference to etiologic factors Thesis, Lund University, Sweden
Gallagher JC, Melton LJ III, Riggs BL (1980) Examination of prevalence rates of possible risk factors in a population with a fracture of the proximal femur. Clin Orthop 153:158
Owen RA, Melton LJ III, Ilstrup DM, Johnson KA, Riggs BL (1982) Colles' fracture and subsequent hip fracture risk. Clin Orthop 171:37–43
Gay JD (1974) Radial fracture as an indicator of osteoporosis: a 10-year follow-up study. Can Med Assoc J 111:156–157
Finsen V, Benum P (1987) Colles' fracture as an indicator of increased risk of hip fracture. An epidemiological study. Ann Chir Gynaecol 76:114–118
Faulkner KG, Glüer C-C, Majumdar S, Lang P, Engelke K, Genant HK (1991) Noninvasive measurements of bone mass, structure, and strength: current methods and experimental techniques. AJR 157:1229–1237
Ott S (1986) Should women get screening bone mass measurements? Ann Intern Med 104:874–876
Cummings SR, Black D (1986) Should perimenopausal women be screened for osteoporosis? Ann Intern Med 104:817–823
Hall FM, Davis MA, Baran DT (1987) Bone mineral screening for osteoporosis. N Engl J Med 316:212–214
Riggs LB, Wahner HW (1988) Bone densitometry and clinical decision making in osteoporosis (Editorial). Ann Intern Med 108:293–295
Genant HK, Block JE, Steiger P, Glueer CC, Ettinger B, Harris ST (1989) Appropriate use of bone densitometry. Radiology 170:817–822
Tosteson ANA, Rosenthal DI, Melton LJ III (1990) Cost effectiveness of screening perimenopausal white women for osteoporosis: bone densitometry and hormone replacement therapy. Ann Intern Med 113:594–603
Raffle AE, Cooper C (1990) Bone density screening for osteoporosis. (Letters to Editor) Lancet 336:242
Hesp R, Klenerman L, Page L (1984) Decreased radial bone mass in Colles' fracture. Acta Orthop Scand 55:573–575
Härmä M, Karjalainen PP (1986) Trabecular osteopenia in Colles' fracture. Acta Orthop Scand 57:38–40
Nordin BE, Wishart JM, Horowitz M, Need AG, Bridges A, Bellon M (1988) The relation between forearm and vertebral mineral density and fractures in postmenopausal women. Bone Miner 5:21–33
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Mallmin, H., Ljunghall, S., Persson, I. et al. Fracture of the distal forearm as a forecaster of subsequent hip fracture: A population-based cohort study with 24 years of follow-up. Calcif Tissue Int 52, 269–272 (1993). https://doi.org/10.1007/BF00296650
Received:
Revised:
Issue Date:
DOI: https://doi.org/10.1007/BF00296650